Reach & Impact: Promising strategies for primary prevention

Transcription

1 Reach & Impact: Promising strategies for primary prevention 4 th Annual Symposium on Occupational Health & Disease Prevention October 29, 2018 Findings of a project supported with funds from WorkSafeBC through the Innovation at Work research program.

2 Background v Why did we do the project? burden of occupational disease is large primary prevention: challenging but essential v What was our objective? identify prevention strategies: 4 occupational diseases v What did we do? scoping review key informant interviews

3 How we collected our data 42,000 articles identified 668 articles retrieved 404 articles reviewed Has program been implemented? Has program been evaluated? Is program relevant to Canadian context? Does program address populations of interest?

4 What we found Breakdown by disease Occupational cancer by carcinogen 17% 31% 30% 47% 21% 13% 26% 15% NIHL Dermatitis Asthma Cancer Asbestos Diesel exhaust Silica Shiftwork

5 A model of primary prevention Legislation & Regulations Surveillance Control Measures Education & Training In the workplace

6 Reporting the findings Legislation & Regulations Surveillance Control Measures Education & Training Multi-faceted approaches Impact on: Exposure Health Behaviour

7 Noise-induced hearing loss Prevention Approach Main Findings 6,535 hits Legislation & regulations Mixed findings 120 articles reviewed 69 evaluated Surveillance Exposure controls Education & training Multi-faceted Reduced noise levels Changed behaviour Reduced noise levels PPE: ineffective Increased awareness Changed behaviour HCP: mixed findings Other: changed behaviour

8 Occupational contact dermatitis Prevention Approach Main Findings 1,020 hits Legislation & regulations Generally, positive impact 53 articles retrieved 43 evaluated Surveillance Exposure controls Education & training Multi-faceted Mixed findings about effect of health screening Positive health outcomes and improved use of PPE Increased knowledge, improved work habits, improved health outcomes Decreased symptoms, positive behavior change

9 Occupational cancer: asbestos Prevention Approach Main Findings 17,503 hits Legislation & regulations Decreased incidence 59 articles reviewed Surveillance Useful for identifying cases, informing prevention 20 evaluated Exposure controls Education & training Increased awareness Multi-faceted Reduced exposure, decreased incidence

10 Occupational cancer: diesel exhaust Prevention Approach Main Findings 5,795 Legislation & regulations Decreased cancer risk 19 articles reviewed 10 evaluated Surveillance Effectively controlled DEE Exposure controls Reduced exposure levels Education & training Multi-faceted Reductions in exposure Decreased risk of cancer

11 Occupational cancer: silica Prevention Approach Main Findings 5,006 hits Legislation & regulations Decreased silica levels 27 articles reviewed 19 evaluated Surveillance Exposure controls Reduced exposure Education & training Increased knowledge, readiness to use controls Multi-faceted Reduced exposure

12 Occupational cancer: shiftwork Prevention Approach Main Findings 2,720 hits Legislation & regulations 22 articles retrieved 6 evaluated Surveillance Exposure controls Improved exposure, reduced health impacts Education & training Improved health outcomes Multi-faceted Improved health outcomes

13 Occupational asthma 104 articles reviewed 3,789 hits Prevention Approach Legislation & regulations Surveillance Main Findings Decrease in number of cases; reduced exposures Early case identification, exposure remediation 55 evaluated Exposure controls Reduce exposure Education & training Multi-faceted Increased awareness, improved long-term retention Reduced disease burden, exposure, number of claims

14 Pulling it all together Legislation & regulations NIHL Contact Dermatitis Occupational Cancer (carcinogens) Asbestos Diesel Exhaust Silica Shiftwork Asthma ( ) Surveillance Exposure control Education & training ( ) Multi-faceted approaches

15 What can we conclude? v Each approach plays important role each insufficient on its own v Multi-faceted approaches more effective v Outcomes influenced by a constellation of factors regulatory frameworks organization size, management structures/culture worker engagement & empowerment

16 Project Team Barbara Neis, Principal Investigator, SafetyNet, Memorial University Stephen Bornstein, Co-P.I., SafetyNet, Memorial University Anya Keefe, Research Coordinator TEAM LEADS Noise-Induced Hearing Loss: Hugh Davies School of Population and Public Health, U. British Columbia Occupational Contact Dermatitis: D. Linn Holness, Medicine and Public Health Sciences, St. Michael s Hospital / U. Toronto Occupational Cancer: Paul Demers Occupational Cancer Research Centre, Cancer Care Ontario Occupational Asthma: Zhiwei Gao / Barbara Neis Clinical Epidemiology, Faculty of Medicine / SafetyNet, Memorial French Literature Susan Stock Institut national de santé publique du Québec/Social & Preventive Medicine, U Montreal RESEARCH PARTNERS Mieke Koehoorn School of Population and Public Health, University of British Columbia Allen Kraut College of Medicine, Faculty of Health Science, University of Manitoba Victoria Arrandale Occupational Cancer Research Centre, Cancer Care Ontario Colin Murray Worker and Employer Services, WorkSafeBC Mary Shortall / Bill Hynd Newfoundland and Labrador Federation of Labour Alec Farquhar Office of the Worker Adviser, Ontario Ministry of Labour RESEARCH STAFF Ruth Buitrago, RA French References Kevin Hedges, RA Occupational Asthma Omid Nobakht, RA Noise-Induced Hearing Loss Kristen Romme, Librarian Consult Catherine Slavik, RA Occupational Cancer Amanda Veglia, RA Occupational Cancer Bethany Zack, RA Occupational Contact Dermatitis